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99 <br /> ANNUAL FEE and REPORT REQUEST RE EIVED <br /> PERMITTEE NAME: Summit Brick & Tile Co. ml� U 9 2001 <br /> PERMIT NO.: M-1985-203 Division of�inerala and Genially <br /> OPERATION NAME: Edmundson Clay Mine <br /> ANNIVERSARY DATE: May 9,2001 <br /> ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br /> COUNTY: Pueblo <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary da a of the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report may to this form. Please mote that an <br /> adequately labeled map that clearly delineates and includes the above elements mays ffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Joseph C. Welte <br /> Permittee Name: Summit Brick& Tile Co. <br /> Address: P.O. Box 533 <br /> Pueblo, CO 81002-0533 <br /> Phone Number: (719) 542-8278 <br /> Fax Number: (719) 542-5243 <br /> If you have additional comments and/or information that should be provided to the Divisi n, please provide it <br /> below or attach it to this form along with your written report and map. Annual Rep rt instructions are <br /> enclosed. <br /> Sig ure of Corporate Officer or 6wner <br /> sly kol <br /> Date <br /> M'TERM ITMASmRDOCU MENr S W-AF-01 <br />